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英国残疾男性和女性获得医疗保健服务情况:横断面数据的二次分析

Access to healthcare for men and women with disabilities in the UK: secondary analysis of cross-sectional data.

作者信息

Sakellariou Dikaios, Rotarou Elena S

机构信息

School of Healthcare Sciences, Cardiff University, Cardiff, UK.

Department of Economics, University of Chile, Santiago, Chile.

出版信息

BMJ Open. 2017 Sep 11;7(8):e016614. doi: 10.1136/bmjopen-2017-016614.

DOI:10.1136/bmjopen-2017-016614
PMID:28893735
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5629679/
Abstract

OBJECTIVES

The aim of this study was to investigate differences in access to healthcare between people with and without disabilities in the UK. The hypotheses were that: (1) people with disabilities would be more likely to have unmet healthcare needs and (2) there would be gender differences, with women more likely to report unmet needs.

SETTING AND PARTICIPANTS

We performed secondary analysis, using logistic regressions, of deidentified cross-sectional data from the European Health Interview Survey, Wave 2. The sample included 12 840 community-dwelling people over the age of 16 from across the UK, 5 236 of whom had a disability. The survey method involved face-to-face and telephone interviews.

OUTCOME MEASURES

Unmet need for healthcare due to long waiting lists or distance or transportation problems; not being able to afford medical examination, treatment, mental healthcare or prescribed medicines. All measures were self-reported.

RESULTS

Adjusting for age, sex and other factors, people with a severe disability had higher odds of facing unmet needs. The largest gap was in 'unmet need for mental healthcare due to cost', where people with a severe disability were 4.5 times (CI 95% 2.2 to 9.2) more likely to face a problem, as well as in 'unmet need due to cost of prescribed medicine', where people with a mild disability had 3.6 (CI 95% 2.2 to 5.9) higher odds of facing a difficulty. Women with a disability were 7.2 times (CI 95% 2.7 to 19.4) more likely to have unmet needs due to cost of care or medication, compared with men with no disability.

CONCLUSIONS

People with disabilities reported worse access to healthcare, with transportation, cost and long waiting lists being the main barriers. These findings are worrying as they illustrate that a section of the population, who may have higher healthcare needs, faces increased barriers in accessing services.

摘要

目标

本研究旨在调查英国残疾人和非残疾人在获得医疗保健方面的差异。研究假设为:(1)残疾人更有可能存在未满足的医疗保健需求;(2)存在性别差异,女性更有可能报告有未满足的需求。

设置与参与者

我们使用逻辑回归对欧洲健康访谈调查第二轮中经过去识别处理的横断面数据进行了二次分析。样本包括来自英国各地的12840名16岁以上的社区居民,其中5236人有残疾。调查方法包括面对面访谈和电话访谈。

结果指标

因等候名单过长、距离或交通问题导致的未满足的医疗保健需求;无力支付体检、治疗、心理保健或处方药费用。所有指标均为自我报告。

结果

在对年龄、性别和其他因素进行调整后,重度残疾人面临未满足需求的几率更高。最大的差距在于“因费用导致的未满足的心理保健需求”,重度残疾人面临该问题的可能性是其他人的4.5倍(95%置信区间为2.2至9.2),以及“因处方药费用导致的未满足需求”,轻度残疾人面临困难的几率高3.6倍(95%置信区间为2.2至5.9)。与无残疾男性相比,残疾女性因护理或药物费用而有未满足需求的可能性高7.2倍(95%置信区间为2.7至19.4)。

结论

残疾人报告称获得医疗保健的情况较差,交通、费用和等候名单过长是主要障碍。这些发现令人担忧,因为它们表明这部分可能有更高医疗保健需求的人群在获得服务方面面临更多障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dec/5629679/1d0c88b60b63/bmjopen-2017-016614f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dec/5629679/1d0c88b60b63/bmjopen-2017-016614f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dec/5629679/1d0c88b60b63/bmjopen-2017-016614f01.jpg

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